400 BCE GREECE Greek physician Hippocrates (460–370 BCE), the “Father of Medicine,” believed illness was caused by imbalance of four bodily humors: yellow bile, black bile, blood, and phlegm. He was the first to recognize differences between benign and malignant tumors.

Circa 250 BCE CHINA The first clinical picture of breast cancer,including progression, metastatis, and death, and prognosis approximately ten years after diagnosis, was described in The Nei Ching, or The Yellow Emperor’s Classic of Internal Medicine. It gave the first description of tumors and five forms of therapy: spiritual, pharmacological, diet, acupuncture, and treatment of respiratory diseases.

50 AD ITALY The Romans found some tumors could be removed by surgery and cauterized, but thought medicine did not work. They noted some tumors grew again.

500 – 1500 EUROPE Surgery and cautery were used on smaller tumors. Caustic pastes, usually containing arsenic, were used on more extensive cancers, as well as phlebotomy (blood-letting), diet, herbal medicines, powder of crab, and symbolic charms.

1492 EUROPE Christopher Columbus returned to Europe from the Americas with the first tobacco leaves and seeds ever seen on the continent. A crew member, Rodrigo de Jerez, was seen smoking and imprisoned by the Inquisition, which believed he was possessed by the devil.

1500 EUROPE Autopsies were conducted more often and understanding of internal cancers grew.

17th century FRANCE Physician Claude Gendron (1663–1750) concluded that cancer arises locally as a hard, growing mass, untreatable with drugs, and that it must be removed with all its “filaments.”

17th century NETHERLANDS Professor Hermann Boerhaave (1668–1738) believed inflammation could result in cancer.

17th – 18th centuries NETHERLANDS Antony van Leeuwenhoek (1632–1723) refined the single lens microscope and was the first to see blood cells and bacteria, aiding the better understanding of cells, blood, and lymphatic system— major steps in improving the understanding of cancer.

1713 ITALY Dr. Bernardino Ramazzini (1633–1714), a founder of occupational/industrial medicine, reported the virtual absence of cervical cancer and relatively high incidence of breast cancer in nuns. This observation was an important step toward identifying hormonal factors such as pregnancy and infections related to sexual contact in cancer risk, and was the first indication that lifestyle might affect the development of cancer.

1733 – 1788 FRANCE Physicians and scientists performed systematic experiments on cancer, leading to oncology as a medical specialty. Two French scientists— physician Jean Astruc and chemist Bernard Peyrilhe— were key to these new investigations.

1761 ITALY Giovanni Morgagni performed the first autopsies to relate the patient’s illness to the science of dis- ease, laying the foundation for modern pathology.

1761 UNITED KINGDOM Dr. John Hill published “Cautions Against the Immoderate Use of Snuff,” the first report linking tobacco and cancer.

1775 UNITED KINGDOM Dr. Percival Pott of Saint Bartholomew’s Hospital in London described cancer in chimney sweeps caused by soot collecting under the scrotum, the first indication that exposure to chemicals in the environment could cause cancer. This research led to many additional studies that identified other occupational carcinogens and thence to public health measures to reduce cancer risk.

1779 FRANCE First cancer hospital founded in Reims. It was forced to move from the city because people believed cancer was contagious.

18th century UNITED KINGDOM Scottish surgeon John Hunter (1728–93) stated that tumors originated in the lymph system and then seeded around the body. He suggested that some cancers might be cured by surgery, especially those that had not invaded nearby tissue.